1. Acromegaly What Causes acromegaly? acromegaly is caused by prolonged overproduction of GH by the pituitary gland. How Common is acromegaly? http://www.niddk.nih.gov/health/endo/pubs/acro/acro.htm

What Causes Acromegaly? How Common is Acromegaly? How is Acromegaly Diagnosed? How is Acromegaly Treated? ... Other Resources Acromegaly is a hormonal disorder that results when the pituitary gland produces excess growth hormone (GH). It most commonly affects middle-aged adults and can result in serious illness and premature death. Once recognized, acromegaly is treatable in most patients, but because of its slow and often insidious onset, it frequently is not diagnosed correctly. The name acromegaly comes from the Greek words for "extremities" and "enlargement" and reflects one of its most common symptoms, the abnormal growth of the hands and feet. Soft tissue swelling of the hands and feet is often an early feature, with patients noticing a change in ring or shoe size. Gradually, bony changes alter the patient's facial features: the brow and lower jaw protrude, the nasal bone enlarges, and spacing of the teeth increases. Overgrowth of bone and cartilage often leads to arthritis. When tissue thickens, it may trap nerves, causing carpal tunnel syndrome, characterized by numbness and weakness of the hands. Other symptoms of acromegaly include thick, coarse, oily skin; skin tags; enlarged lips, nose and tongue; deepening of the voice due to enlarged sinuses and vocal cords; snoring due to upper airway obstruction; excessive sweating and skin odor; fatigue and weakness; headaches; impaired vision; abnormalities of the menstrual cycle and sometimes breast discharge in women; and impotence in men. There may be enlargement of body organs, including the liver, spleen, kidneys and heart.

2. Acromegaly - Endocrinology Health Guide This health guide deals with acromegaly, a pituitary disorder caused by excess growth hormones. Symptoms and treatments are discussed. acromegaly. http://www.umm.edu/endocrin/acromegaly.htm

Endocrinology Health Guide... Pituitary Gland Disorders... Pituitary Tumors Acromegaly ... Glossary Related Resources Within UMM Endocrinology Joslin Diabetes Center School of Medicine Endocrinology Site Endocrinology Health Guide Acromegaly What is acromegaly? Acromegaly is the Greek word for "extremities" and "enlargement." When the pituitary gland produces excess growth hormones, this results in excessive growth called acromegaly. The excessive growth occurs first in the hands and feet, as soft tissue begins to swell. Acromegaly affects mostly middle-aged adults. Untreated, the disease can lead to severe illness and death. What are the symptoms of acromegaly? Symptoms of acromegaly vary depending on how long the patient has had the disease. The following are the most common symptoms. However, each individual may experience symptoms differently: swelling of the hands and feet facial features become coarse as bones grow body hair becomes coarse as the skin thickens and/or darkens increased perspiration accompanied with body odor protruding jaw voice deepening enlarged lip, nose, and tongue

3. EMedicine - Acromegaly : Article By Hasnain M Khandwala, MD a GHsecreting pituitary tumor (somatotroph tumor), characterizes acromegaly. Other causes of increased and unregulated An audit of outcome of treatment in acromegaly. Q J Med 1993 http://www.emedicine.com/med/topic27.htm

(advertisement) Home Specialties Resource Centers CME ... Patient Education Articles Images CME Patient Education Advanced Search Consumer Health Link to this site Back to: eMedicine Specialties Medicine, Ob/Gyn, Psychiatry, and Surgery Endocrinology Acromegaly Last Updated: November 25, 2003 Rate this Article Email to a Colleague Synonyms and related keywords: growth hormone, GH, somatotroph tumor, growth hormone-releasing hormone, GHRH, insulinlike growth factor-I, IGF-I, somatomedin C, SM-C, guanosine triphosphate, GTP, glycogen synthetase phosphatase, GSP, acral overgrowth, macrognathia, visceral overgrowth, macroglossia, panhypopituitarism, somatic hypertrophy, hypertrophic arthropathy, kyphosis, hyperhidrosis, visceral hypersomia, multinodular goiter, colon polyposis, pseudoacromegaly, transsphenoidal hypophysectomy, somatostatin analogues, dopamine agonists, Immediate Response Mobile Analysis, IRMA AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography Author: Hasnain M Khandwala, MD

4. Acromegaly of Dermatology University of Iowa College of Medicine. acromegaly - Hands - Normal female hand for comparison. For more information see the Online Mendelian Inheritance in Man (OMIM). Return to Image Index page. Return to Image Index page. http://tray.dermatology.uiowa.edu/Acromeg.htm

Dept. of Dermatology - University of Iowa College of Medicine Acromegaly - Hands - Normal female hand for comparison. For more information see the Online Mendelian Inheritance in Man (OMIM) Return to Image Index page. Return to Image Index page. Return to Dermatology's Home page. September, 1995

5. Acromegaly & Gigantism - Endocrinology - Medstudents A review of acromegaly Gigantism with focus on etiology, pathogenesis and treatment. Endocrinology. Medstudents Homepage. acromegaly Gigantism. Introduction. http://www.medstudents.com.br/endoc/endoc8.htm

Endocrinology Karina Naomi Une Medstudents' Homepage Introduction Acromegaly/Gigantism is a very rare disease (annual incidence: 3/1.000.000). The syndrome results from a chronic exposure to GH (Growth Hormone) leading to the classic clinical features that the diagnosis seems to be easy. High exposure to GH produces gigantism in youths prior to epiphyseal fusion and acromegaly in adults. The early diagnosis and intervention may prevent irreversible changes associated with chronic overproduction of GH (as well IGF-1) and may also normalize life expectancy. These patients have an increased mortality rate from systemic sequela of hypersomatotrophism in 2-4 times that of the healthy population. Etiology Acromegaly/Gigantism is the second in frequency of Pituitary Adenomas, accounting for about 17% of them. It is often caused by a pituitary adenoma GH secreting (99%), but other causes has been described such as: A rare form caused by hypersecretion of GHRH from an ectopic source (pancreatic islet or carcinoid tumors) or from within the central nervous system such as ganglyoneuroma (called eutopic ). Even more rare form is a

6. MedlinePlus Medical Encyclopedia: Acromegaly acromegaly is a chronic metabolic disorder caused by the presence of too much growth hormone Return to top. acromegaly occurs in about 6 of every 100 000 adults http://www.nlm.nih.gov/medlineplus/ency/article/000321.htm

@import url(http://www.nlm.nih.gov/medlineplus/images/advanced.css); Skip navigation Medical Encyclopedia Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Acromegaly Contents of this page: Illustrations Alternative names Definition Causes, incidence, and risk factors ... Prevention Illustrations Endocrine glands Alternative names Return to top Somatotroph adenoma; Growth hormone excess Definition Return to top Acromegaly is a chronic metabolic disorder caused by the presence of too much growth hormone. It results in gradual enlargement of body tissues including the bones of the face, jaw, hands, feet, and skull. Causes, incidence, and risk factors Return to top Acromegaly occurs in about 6 of every 100,000 adults. It is caused by abnormal production of growth hormone after normal growth of the skeleton and other organs is complete. Excessive production of growth hormone in children causes gigantism rather than acromegaly. The cause of the increased hormone secretion is usually a benign tumor of the pituitary gland. The pituitary gland, which is located just below the brain, controls the production and release of several different hormones including growth hormone. There are no known risk factors for acromegaly other than a prior history of a pituitary tumor.

7. Neuromuscular + Endocrine Disease acromegaly Cushing The pituitary body its disorders. Before disease, Disease onset. Square hand, Phalanges Tufting; Exostoses. acromegaly. http://www.neuro.wustl.edu/neuromuscular/msys/mend.htm

Front Search Index Links ... Adrenal Carcinoid myopathy Corticosteroid Diabetes Gonadal Dysgenesis Gynecomastia Insulinoma Parathyroid ... Hypothyroid From Bramwell : Atlas of Clinical Medicine Myxedema THYROID DISEASE Hyperthyroid Myopathy Ophthalmopathy ... Other associated disorders External link: Testing From Bramwell : Atlas of Clinical Medicine Hypothyroidism Adult History Muscle pain cramps Fatigue Paresthesias Myopathy Weakness Mild (4/5) Symmetric Proximal Occasional: Posterior neck Cramps (40%) Muscle contraction: Slow; Delayed relaxation Muscle enlargement : Occasional (Hoffman's syndrome) Myoedema (33%): Local contracture after muscle tap or pinch Myokymia Associated with Na loss May be associated with ptosis Tendon reflexes: Reduced or Delayed Rhabdomyolysis Course Progression of weakness: Slow over months Resolution of weakness after treatment: Slow over months Neuropathy Carpal tunnel syndrome Cranial nerves : Deafness; Hoarse voice (Local vocal cord lesion) Polyneuropathy (19%): Sensory; Axonal Tendon reflexes: Reduced Ankle reflex Lab Low free thyroxine TSH Primary hypothyroidism: High Pituitary-Hypothalamic disease: Low CK Very High in some patients No correlation with weakness EMG: Normal or mildly myopathic Muscle pathology Usual: Non-specific Pale central regions on NADH Some patients: Accumulation of PAS staining material in muscle fibers Treatment: Thyroid replacement Strength recovers Weakness Slow movements Muscle hypertrophy Growth retardation Hypothyroid: Other associated neuromuscular disorders Myasthenia gravis : Exacerbation of preexisting disease

8. ––’[”ì‘åÇ(Acromegaly)‚Ƃ̏o‰ï‚¢‚»‚µ‚Ä•Ê‚ê è„³ä¸‹åž‚ä½“è ºè «ã®ä¸€ç¨®ã§ã‚ã‚‹æœ«ç«¯è‚¥å¤§ç—‡ã®ä½“é¨“è¨˜ã€‚ç— æ°—ã®æƒ å ±ã€æ²»ç™‚æ³•ãªã©ã€‚ http://www.geocities.co.jp/Beautycare/3995/

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9. Acromegaly a CHORUS notecard document about acromegaly Feedback. Search. acromegaly. excess growth hormone due to eosinophilic adenoma/hyperplasia http://chorus.rad.mcw.edu/doc/00971.html

CHORUS Collaborative Hypertext of Radiology Musculoskeletal system Feedback Search acromegaly excess growth hormone due to eosinophilic adenoma /hyperplasia osseous enlargement (phalangeal tufts, vertebrae) flared ends of long bones cystic changes in carpals, femoral trochanters osteoporosis spade-like hand prognathism (elongation of mandible) in few cases sellar enlargement and erosion enlarged paranasal sinuses (esp. frontal): 75% calvarial hyperostosis (esp. inner table) enlarged occipital protuberance vertebrae: posterior scalloping (30%), anterior new bone, loss of disc space heel pad premature osteoarthritis (commonly knees) Yong H. Hahn, MD - 2 February 1995 Last updated 26 May 2004 Medical College of Wisconsin

10. Discovery Health Acromegaly acromegaly is excessive bone growth. It results when a person's body produces too much growth hormone. The condition causes gradual enlargement of the bones in the face, jaw, hands, feet, and acromegalyBy Gail Hendrickson, RN, BS. acromegaly is excessive bone growth http://health.discovery.com/diseasesandcond/encyclopedia/480.html

11. OHSU Pituitary Unit - Acromegaly acromegaly is a condition resulting from excess growth hormone production. Most cases of acromegaly are caused by pituitary tumors. The OHSU Pituitary Unit offers comprehensive treatment for patients with acromegaly. http://www.ohsuhealth.com/pituitary/patients/acromeg.asp

Introduction About The Pituitary Diseases Of The Pituitary Prolactinoma ... Cushing's Disease Acromegaly Hormone Deficiency And Replacement Streaming Video: Doctor/Patient Discussions (coming soon) How Do I Work With My Doctor To Find Out If I Have A Pituitary Disorder Diagnosed With A Pituitary Tumor - What Should I Do Next? ... I Have A Question Acromegaly Approximately 10% of pituitary adenomas secrete excess growth hormone (GH) which in adults causes a disease called acromegaly. The word "acromegaly" is of Greek derivation and literally means, "enlarged extremities". The vast majority of cases of acromegaly are caused by pituitary adenomas but other causes include tumors of the pancreas, lungs or adrenal glands. This section will focus on acromegaly caused by pituitary tumors. Acromegaly Quick Link to topics below Diagnosis Treatment New Treatment Options Assessment of Cure or Adequacy of Treatment ... Long-term Course and Potential Complications Signs and Symptoms Due to the slow growth of GH secreting pituitary tumors, the physical characteristics of acromegaly typically develop very slowly over several decades. Acromegaly is particularly characterized by skeletal changes including enlarging hands and feet. For example, patients often recall having to resize their rings several times over a 15 to 20 year period and/or having to increase shoe size several times over the same time frame. Other skeletal changes include enlarging jaw and brow (frontal bossing). Despite the characteristic features of acromegaly, the gradual onset of physical changes often result in the disease being clinically missed for years. In fact, these tumors are often detected because of a mass effect (e.g., headaches, visual changes, other pituitary hormone deficiencies) rather than the physical changes caused by GH excess. Common features of acromegaly are listed in Table 1.

12. U.S. Sandostatin - Sandostatin And Acromegaly Information Both patient and professional information about acromegaly and GEP tumors and treatment with Sandostatin LAR Depot. Directed towards US residents. http://www.us.sandostatin.com

About Acromegaly About Carcinoid Syndrome Important Safety Information Prescribing Information ... Healthcare Professionals var buiContextPath = ""; E-mail this page Living with Acromegaly Acromegaly is a rare disease that affects about 40 out of every million people in the U.S. If you or someone close to you has been diagnosed with acromegaly, this section will help answer your initial questions. It offers information on acromegaly, its diagnosis and available treatment options. Living with Carcinoid Syndrome If you or someone close to you has been told they have carcinoid syndrome, you may be looking for the facts concerning this rare and chronic condition. This section offers information on carcinoid syndrome and VIPoma, their diagnosis, and available treatment. Site Guide Contact Us Sandostatin site survey X Please help us make this site better by answering these survey questions. We are not collecting any personally identifiable information. See our I am a (choose one) patient diagnosed with select one Acromegaly Carcinoid syndrome other Specify (Other) when diagnosed?:

13. The Methodist Hospital - Data Not Available Methodist Health Care System looks at what this disease is, its symptoms, diagnosis and treatment. http://methodisthealth.com/endocrin/acromegaly.htm

We're very sorry, but data for this page is currently unavailable. This page is currently not available. Please notify us of this occurrence by filling out our Contact Us form. Click the Back button and try a different option from the Menu. We appreciate your continued support, and sincerely apologize for the inconvenience. Please check back later to access this page. Methodist Customer Support

14. ► Acromegaly Spanish acromegaly. Definition acromegaly is a chronic metabolic disorder caused by the presence of too much growth hormone. It http://www.umm.edu/ency/article/000321.htm

Disease Nutrition Surgery Symptoms Injury ... Encyclopedia (English) Toggle English Spanish Acromegaly Overview Symptoms Treatment Prevention Definition: Acromegaly is a chronic metabolic disorder caused by the presence of too much growth hormone. It results in gradual enlargement of body tissues including the bones of the face, jaw, hands, feet, and skull. Alternative Names: Somatotroph adenoma; Growth hormone excess Causes, incidence, and risk factors: Acromegaly occurs in about 6 of every 100,000 adults. It is caused by abnormal production of growth hormone after normal growth of the skeleton and other organs is complete. Excessive production of growth hormone in children causes gigantism rather than acromegaly. The cause of the increased hormone secretion is usually a benign tumor of the pituitary gland. The pituitary gland, which is located just below the brain, controls the production and release of several different hormones including growth hormone. There are no known risk factors for acromegaly other than a prior history of a pituitary tumor. Endocrine glands Review Date: 5/12/2002 Reviewed By: Stephanie Fish, M.D., Division of Endocrinology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

15. OHSU Pituitary Unit - Pituitary Tumor And Disease Treatment Center Pituitary tumor and pituitary disease treatment center. Information on managing a pituitary tumor or disease.The OHSU Pituitary Unit treats pituitary tumors and pituitary diseases including Cushing's Disease, acromegaly, and Prolactinomas. http://www.ohsuhealth.com/pituitary/

A comprehensive treatment center for the management of pituitary tumors and diseases of the pituitary gland Click on the title above to read about the role of the pituitary gland and the characteristics of pituitary disease. Learn how to determine if you have a pituitary tumor or disorder. Utilize multiple patient support resources including the ability to ask general questions of an OHSU neuroendocrinologist. Click on the title above to get valuable information to help you recognize patients with a pituitary tumor or disorder. Review case studies and utilize other educational tools. Gain rapid clinical access to an OHSU neuroendocrinologist for questions and referrals. Click on the title above to learn about the outstanding faculty and resources of the OHSU Pituitary Unit. Services include neurosurgical treatment of pituitary tumors utilizing intraoperative MRI, interventional neuroradiology and radiation-oncology. See recent news releases and other updates about the OHSU Pituitary Unit. OHSU Pituitary Home Site Map Contact OHSU Pituitary Unit Terms and Conditions ... OHSU Notice of Privacy Practices

16. Sandostatin.com Global For Healthcare Professionals - Sandostatin LAR Home International site for this medication used for acromegaly. Includes information on acromegaly, GEP tumors, case studies, physicians roster, journal articles, and slide library. http://www.sandostatin.com

generateButtons(0,6,"images/","tnav",false); Search Subscribe to Our Endocrine and Pituitary Newsletter What matters most in treating Acromegaly controls the 'Critical 4' GH suppression in 68%-72% of patients IGF-I normalisation in 65%-75% of patients Tumour shrinkage in 46%-77% of patients Symptoms control (headache, fatigue, perspiration, arthralgia, paraesthesias) works at the site of the tumour, binding to sst-2/sst-5 receptors to regulate GH secretion and cell growth About Acromegaly Acromegaly is a rare and complex disease caused by overproduction of growth hormone. Diagnosing Acromegaly Treating Acromegaly What matters most in treating GEP NE Tumours Suppresses 5-HIAA by up to 50%(Lanreotide: 24%) Reduces diarrhoea frequency by 42% (Lanreotide: 19%) Reduces flushing frequency by 84% (Lanreotide: 56%) works at the site of the tumour, binding to sst-2/sst-5 receptors to regulate gastrointestinal hormone secretion and affect tumour growth About GEP NE Tumours Gastro-entero-pancreatic neuroendocrine (GEP NE) tumours are tumours that are located in the digestive tract. Diagnosing GEP NE Tumours Treating GEP NE Tumours Learn More Resources for Patients Our Newsletter What's New ASCO June 5 - 8, 2004, New Orleans, Louisiana, USA

17. The Methodist Hospital - Data Not Available We're very sorry, but data for this page is currently unavailable. This page is currently not available. Please notify us of this occurrence by filling out our Contact Us form. Click the Back button http://www.methodisthealth.com/endocrin/acromegaly.htm

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18. Pituitary Network Association - Disorders - Acromegaly Pituitary Network Association Pituitary Network Association - Disorders - acromegaly. acromegaly. Please click onto www.acromegaly.org for further information. http://www.pituitary.com/disorders/acromegaly.php

Acromegaly Please click onto www.acromegaly.org for further information Acromegaly is a serious systemic condition caused in over 98% of cases by an adenoma (i.e., benign tumor) of the pituitary gland that secretes excessive growth hormone (GH). The clinical features associated with acromegaly include the effects of GH over-production, and in some instances by the tumor compressing and injuring the normal pituitary gland, optic nerves and optic chiasm. Untreated acromegaly results in marked bony and soft tissue changes including an altered facial appearance (frontal bossing, prognathism), enlargement of the hands and feet, sleep apnea, and carpal tunnel syndrome. More serious problems may include accelerated cardiovascular disease, hypertension, diabetes mellitus and possibly an increased risk of colon cancer. If the tumor develops before bone growth is completed in adolescence, the result will be gigantism. Because of the serious systemic changes resulting from GH excess, treatment is essential, typically with transsphenoidal surgery. Symptoms and signs may include: Soft tissue thickening of the palms of the hands and soles of the feet Enlargement of hands (ring size), feet (shoe size) and head (hat size)

19. U.S. Sandostatin - Sandostatin And Acromegaly Information Sandostatin LAR Depot is a product indicated for longterm maintenance therapy in acromegalic patients. The site is directed towards US residents and contains two links, one for patient Living with acromegaly. acromegaly is a rare disease that affects about 40 out of every million people in you has been diagnosed with acromegaly, this section will help answer your http://rdre1.inktomi.com/click?u=http://www.us.sandostatin.com/&y=0218114DE5

20. Pituitary Network Association - Acromegaly Survey Pituitary Network Association Pituitary Network Association - acromegaly Survey. acromegaly Survey. acromegaly DIAGNOSING A RETROSPECTIVE SURVEY. http://www.pituitary.com/surveys/Acromegaly_Survey.php

Acromegaly Survey ACROMEGALY DIAGNOSING A RETROSPECTIVE SURVEY DIRECTIONS FOR COMPLETING QUESTIONNAIRE: DEMOGRAPHICS: GENERAL: PLEASE GIVE ALL NUMERICAL INFORMATION ROUNDED TO NEAREST WHOLE NUMBER EXAMPLES: 1YEAR 6 MONTHS = 2 YRS. GENDER: Select Male Female LEVEL OF EDUCATION: Select Less Than High School High School Diploma Some College Bachelor's Degree Some Graduate Graduate Degree Some Ph.D. Ph.D. INCOME LEVEL: Select Over $90,000 Marital Status: Select Married Single Divorced Widowed Seperated Present Age: Country You Live In: State/Province you live in: Do you have a family history of acromegaly: Select Yes No If yes, what relationship: Have you had a pituitary tumor removed: Select Yes No Are you on medication for your acromegaly: Select Yes No If yes, what medication:

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